Cervicobrachial Pain and Cancer

This chapter presents the case of a man operated on for lung cancer who has a unique bone cervical metastasis responsible for nociceptive pain at the neck responding to opioids and neuropathic pain with burning and innumerable pain paroxysms (electric shocks) at the arm, which are not alleviated by opioids. In this case, transmucosal fentanyl is not mandatory because pain paroxysms are innumerable and of neuropathic origin. In this context, it is advisable to introduce an antineuropathic drug, such as pregabalin or gabapentin, in combination with oral morphine. Neuropathic pain affects up to 40% of cancer patients and is associated with increased pain intensity, analgesic consumption, and decreased quality of life.